This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The proposed human research initiative takes advantage of several strengths at the University of Florida the most important of which is the Laboratory of Inflammation Biology and Surgical Science with recognized expertise in the application of functional genomics and proteomics to human disease. Using these resources, the study aims to test the hypothesis that the systemic inflammatory response following vascular intervention influences the local milieu responsible for vascular repair and adaptation. The expectation being that this response is not uniform in all patients, but rather, is modulated by either some preoperative genetic predisposition or differential periprocedural regulation of monocyte function that drives the vascular response towards an occlusive maladaptive phenotype. Early intervention failure with recurrent lower extremity ischemia and a negative impact on quality of life is the potential result. Peripheral arterial occlusive disease is a significant national health care concern and the information gained through this work will lead to new strategies to improve existing approaches to lower extremity revascularization. It will also provide new knowledge in the overall management of peripheral vascular disease on a significantly broader scope.